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Renal sympathetic denervation is under investigation as a therapeutic option for hypertension that has not responded to ≥3 antihypertensive drugs (resistant hypertension).1
MECHANISM OF ACTION — Activation of efferent renal sympathetic nerves results in increased norepinephrine release, increased renin secretion, increased sodium and fluid reabsorption, and decreased renal blood flow and glomerular filtration rate. In addition, excitatory afferent nerves from the kidney stimulate central sympathetic nervous system activation.
Bilateral renal denervation has been shown to decrease systemic blood pressure in animals, and decades ago, surgical sympathectomy was shown to improve blood pressure and outcomes in hypertensive patients,2 but it was abandoned with the advent of effective antihypertensive drug therapy.